骨质疏松性骨折人群跌倒风险、骨密度、肌力和体脂的相关性

Association of fall risk,bone mineral density,muscle strength,and body fat content in patients with osteoporotic fractures

目的探讨骨质疏松性骨折人群的骨密度与跌倒风险、体质量指数(body mass index,BMI)、肌力、体脂含量的相关性。方法通过对4 632例社区45岁以上绝经后女性的问卷调研及骨密度筛查,筛查出既往有脆性骨折史的骨质疏松性骨折人群。测定骨质疏松性骨折人群的骨密度、身高、体质量、跌倒风险、肌力和腹部脂肪含量。采用Spearman检验分析跌倒指数、体脂含量、年龄、身高、体质量、BMI与骨密度(bone mass density,BMD)之间的相关性。BMD校正年龄、身高、体质量、BMI、体脂含量,采用ANCOVA分析跌倒指数对BMD的影响;校正年龄、身高、体质量、BMI、跌倒指数,分析体脂含量对BMD的影响。结果对筛查出的839例骨质疏松性骨折患者的BMD、BMI、跌倒风险、腹部体脂含量、肌力等相关性分析结果显示,骨质疏松性骨折人群BMI、跌倒指数、肌力与BMD均显著相关(BMI r=0.161,跌倒指数r=0.238,肌力r=0.198,P均<0.001)。BMI、肌力、跌倒风险与BMD呈正相关;校正年龄、身高、体质量、BMI等因素,采用ANCOVA分析跌倒指数与BMD无显著相关(F=1.011,P>0.05)。结论跌倒风险和低BMD为骨折的主要危险因素。本研究显示体脂含量与BMD呈显著相关性。

Objective To evaluate the association of bone mineral density （BMD）, fall risk, body mass index （BMI）, muscle strength, and body fat content in patients with osteoporotic fractures. Methods Totally 4 632 postmenopausal women over age 45 were screened using a questionnaire survey and BMD was measured. BMD, height, weight, fall risk, muscle strength, and abdominal fat content were measured among qualified patients, and correlation among these factors was subsequently analyzed by the Spearman Test. Adjustment for age, sex, height, weight, BMI and body fat content allowed for correlation analysis between fall index and BMD by ANCOVA. Adjustment for age, height, weight, BMI, and fall index allowed the analysis of the correlation between body fat content and BMD. Results A total of 839 osteoporotic patients with a history＂ of brittle fi＇actures were qualified and included for further analysis. The results showed significant correlation between BMD and BMI, and fall index, and muscle strength in these osteoporotie fracture cases （BMI r =0. 161 , the fall index r =0.238, muscle strength, r =0. 198, all P ：0.000）. BMI, muscle strength and fall risk were positively correlated with BMD. When corrected for age, sex, height, weight, body mass index and body fat content, there was no significant con＇elation between the fall index and BMD based on ANCOVA analysis （F = 1.011, P 〉0. 05）. Conclusions Fall risk and low BMD were two main risk factors of fracture. Muscle strength and body fat content were significantly correlated with BMD.